WeVote
Log In

Bill

Bill

SB 247

prohibiting network exclusion for pharmacies that refuse to dispense a prescription of the PBM reimbursement that is below the pharmacy's acquisition cost.

2025 Regular Session Introduced by Kevin Avard and 4 co-sponsors

SB 247 prevents PBM network removal of pharmacies that refuse below-cost prescriptions, protecting independent pharmacy margins but constraining PBM cost-control tools.

Committee Report: Refer for Interim Study 10/28/2025 (Vote 17-0; CC)
0
WeVote Research Nonpartisan
Bill Summary · SB 247

Legislative bill overview

SB 247 would prohibit Pharmacy Benefit Managers (PBMs) from removing pharmacies from their networks if those pharmacies refuse to fill prescriptions when the PBM's reimbursement rate falls below the pharmacy's actual acquisition cost. The bill essentially protects pharmacies from network exclusion when accepting a prescription would result in them operating at a loss.

Why is this important

Pharmacy reimbursement rates have become increasingly contentious, with PBMs often setting rates below what pharmacies actually pay for medications, squeezing margins and forcing difficult business decisions. This bill addresses a real market dynamic where independent and smaller pharmacies face either accepting unprofitable transactions or risking removal from insurance networks that may represent significant portions of their patient base. The outcome affects medication access, pharmacy viability, and healthcare costs.

Potential points of contention

  • PBM business model conflict: PBMs argue low reimbursement rates help control drug costs; this bill constrains their pricing leverage and may increase overall healthcare expenses passed to insurers and patients
  • Network adequacy concerns: Forcing PBMs to keep unprofitable pharmacies in networks could reduce incentives for efficient pharmacy networks or create perverse incentives for pharmacies to claim artificially high acquisition costs
  • Definition and enforcement complexity: "Acquisition cost" can be disputed (different pharmacies pay different prices; wholesaler rebates complicate calculations), making the law difficult to enforce and litigate

Compiled from official sources — confirm details with the bill’s official record.

Sign in to ask a question.